Springfield daily republic. [volume] (Springfield, O. [Ohio]) 1887-1888, 1887-01-11
ANTISEPTIC SURGERY.
PROGRESS MADE IN THE ART
WITHIN A FEW YEARS.

Improved Methods OF Surgery Which
Produce Astounding Notwithstanding
! of Wounds by First Intention"-Ns-
! cessity of Cleanliness-Dressing.
! Fifty years ago, on the minutes of the
/ Pennsylvania hospital in this city, especial
mention was made Of the fact that an
! amputated finger had healed by first
! intention" that is, without the process
! of suppuration and granulation, which is
/ the usual mode by which tissues heal
! At the present time ii is usual, and not
[ unusual, TO have an amputated leg heal
/ by the first intention" as well as the
| wounds made in the performance Of
nearly all major and minor operations Of
surgery.
| So rapid has beer the progress in the
| improved methods of what Is known as
antiseptic surgery that many medical
men are astOunded TO hear of the results
that are being obtained, and the general
, public are not at all aware of the great
advances in the surgical art. Indeed, an
tiseptic surgery has been in its infancy
for less than a dozen years, and has only
received its perfect application within
few months.
In the human body there exists a repar-
ative power by which the separated frGg-
mentS of a broken bone are united and the
cut surfaces of a wound are united. Ths
simplest mode of healing an open wound
is by the first intention" or immediate
union" for which surgeons have aimed
for hundreds Of years. They had OBJ
served it in rare instances, and looked
upon it rs possibility; but, as previously
stated, they seldom succeeded in getting
it, and the instances in which they did
get it were deserving OF special note. If
union fails. by the first intention in
ffammation supervenes, and healing is ac-
complished by long and tedious process
of suppuration and Cranulation, requiring
several weeks or perhaps months for the
closure of n wound of any considerable
size. And this is always connected with
great drain on the vital forces, and dam
ger from blood poisoning.
THE MODERN METHOD.
What is antiseptic SURGERY II con-
siSts OF certain precautions and appli
ances for the exclusion of the air, and
with the air of the numerous germs of
disease and putrefaction which float in
it, and the application of q germicide,
which destroys the vitality Of these germs
during and after operation. The more
perfectly this is done the more likely will
there be procured the primary union, or
union by first intention" Everybody
knows that cut of a finger, IL promptly
tied up and kept at rest, will heal readily;
but if it be neglected and allowed to get
particles of dirt and the germs Of disease
into it there is considerable Inflammation,
the injured member becomes painful and
swollen. discharges matter and is slow to
AM hn cd
plicity of domestic practicable accurate
coaptat;on of the parts, provision being
made for the free discharge OF secretions
from the wound and the seclusiOn of the
air and germs of disease By the adoption
of antiseptic measures the surgeon simply
follows natures Indication He puts the
parts in the best possible condition to heal
and nature does the healing
The methods adopted in order TO secure
this success are simple, and but little
more expensive, considering the first cost,
but infinitely less costly than the old way
of dressing, when consideration is made
for the time and waste of repeated dress
ings, and the lessened risk of blood poison
ing and death from exhaustion from pro-
longed suppuration.
CLEANLINESS ESSENTIAL.
The most essential element in antiseptic
surgery is cleanliness. The part to be
operated upon, or the point Of injury and
adjacent tissue, is first thoroughly
scrubbed with soap and a fine brush. 1t
is then shaved to remove hair and dead
cutaneOus cells, and afterwards washed
with ether, to remove fat and oily matter.
1t is then washed with an antiseptic solu-
ton, and the operation is begun. 4 small
- . L.. ~, - II rh,
parts at short intervals as the operation
progresses. Every opening in the tissues
is washed out with this solution The parts
are brought together with catgut sutures,
which have been rendered aseptic, and
these sutures are absorbed; consequently,
there is nothing to como away. Catgut,
being an animal tissue, is capable of ab-
sorption, and is used for Hgaturing vessels,
sewing up the parts, and for drainage.
For this purpose several strands are placed
in the deeper part OF a wound and drain
by capiIlarity. After there are no further
secretions these are absorbed.
After the superficial opening has been
closed and the edges brought into close
opposition, a strip of protective" is laid
over the line Of sutures. Over this is spread
a fold of several thicknesses Of gauze, an
lIsSpllSdht picPuicu- dAu
on its surface with iodoform. Over this Is
placed cotton, also rendered antiseptic, and
the whole dressing is confined in place by
roller bandases. This dressing is put on
wet-all wet, and almost dripping with
the artiseptic solution. The dressing is
not changed, unless there is some sign that
all is not doing well, until q proper time
has elapsed and it is known that the parts
have healed. Under these methods hos
pital gangrene and erysipelas are very
rarely encountered, and there is so little
discharge of pus that recently it was i'm
possible to get enough for a sample for
exhibition 10 q class at . medical college.
This method, with slight changes in the
detail, is now employed at every good hos
pital in the country and by every surgeon
who is up with the times.-Philadelph
North American.